Subacute Cutaneous Lupus Defined

Subacute Cutaneous Lupus Results in Mild Skin Disease

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People with lupus know the disease can affect various parts of their body, both inside and out, in a variety of ways. But one of the clearest signs that a person has developed the disease is the way it affects the skin (cutaneous disease).

There are, generally speaking, three types of lupus skin disease: chronic cutaneous (discoid lupus), subacute cutaneous, and acute cutaneous.

Some people with discoid lupus may never develop the systemic version of the disease (systemic lupus erythematosus).

And those with subacute cutaneous lupus may develop arthritis, for example, while those with acute cutaneous lupus typically are people with active SLE.

Subacute cutaneous lesions are defined by their two clinical forms:

  • A psoriasis-like lesion with red scaly patches on the arms, shoulders, neck, and trunk and fewer patches on the face.
  • A red ring-shaped lesion with a slight scale on the edges.

Those with photosensitivity and lupus skin disease should avoid natural sunlight and tanning beds as this photosensitivity will exacerbate the disease.

As with discoid lupus, lesions can be treated with the application of corticosteroid creams, ointments, gels, tapes, and solutions. Individual lesions can be injected with a corticosteroid suspension. For persistent rash, anti-malarial drugs may be used.

More information about subacute cutaneous lupus

The skin symptoms of subacute cutaneous lupus are usually mild.

People with this condition present with reddish-purple plaques. Of note, a plaque is a firm and raised flattened skin lesion. These plaques can be found alone or in groups and range in size from 5 to 20 mm. In people with subacute cutaneous lupus, these plaques usually appear on the trunk, including the upper chest and back.

How to treat subacute cutaneous lupus

The plaques of subacute cutaneous lupus should first be treated locally with extra-strength corticosteroid creams or ointments. These creams can be applied to the lesions at night before sleep and then wrapped in plastic film (think Saran Wrap). Alternatively, these plaques can be covered in Cordran tape.

If the plaques are left without a Saran Wrap or tape cover, the corticosteroid ointments and gels should be applied twice a day.

Another way to locally treat the plaques caused by subacute cutaneous lupus is to inject synthetic steroid (Kenalog) into these skin lesions.

When local treatment for these plaques doesn't work, systemic treatments can be tried.

Systemic treatments for subacute cutaneous lupus include the following:

  • antimalarials or drugs used to treat malaria (for example, hydroxychloroquine sulfate, chloroquine or Atabrine);
  • isoretinoin;
  • thalidomide.

It should be noted that one possible adverse effect of antimalarial drugs is psoriasis, which is another type of skin disease that presents similarly to subacute cutaneous lupus.

Finally, isoretinoin and thalidomide are both teratogens, which means that these drugs can damage the fetus. Thus, these drugs shouldn't be taken by people who are pregnant or thinking about getting pregnant.


Lupus and the Skin. American Academy of Dermatology. December 2006.
Symptoms The Lupus Foundation of America. June 2007.

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